Mory Gould

Platelet-rich plasma (PRP) and recombinant human platelet-derived growth factor-BB (rhPDGF-BB) are both used in aesthetic medicine but have never been directly compared. They differ in origin, route of administration, and regulatory status, and neither is FDA approved for aesthetic use. This structured narrative review was reported in accordance with PRISMA 2020, PRISMA-S, and SWiM. PubMed was searched on May 5, 2026, using 4 strategies covering PRP/platelet-rich fibrin (PRF) in aesthetic, scar, and hair restoration applications; rhPDGF-BB/becaplermin in cutaneous wound healing; PRP preparation and reporting quality; and PDGF-related hair follicle biology. A total of 3667 records were identified, of which 36 met inclusion criteria. PRP had the broader aesthetic evidence base, with meta-analyses reporting hair density gains of ∼+25 to +40 hairs/cm2, but preparation and reporting were inconsistent, with only 12.1% of studies providing reproducible protocols and 26.6% reporting final product composition. Measured growth factor concentrations, including PDGF, did not consistently correlate with clinical outcomes. rhPDGF-BB provides defined dosing and benefit in diabetic wound closure (odds ratio, 1.53; 95% CI, 1.14-2.04), but aesthetic evidence is limited to controlled studies of 5 to 12 participants with follow-up of 6 months or less. No head-to-head aesthetic trials exist. PRP is supported by broader clinical experience, whereas rhPDGF-BB offers greater standardization whose aesthetic value remains unestablished. Because the agents are delivered by different routes to different populations, these findings describe parallel evidentiary paradigms rather than a comparison of interchangeable therapies. Standardization should not be interpreted as evidence of superior clinical efficacy. Level of Evidence: 3 (Therapeutic) For image description, please refer to the figure legend and surrounding text.

Patients increasingly form expectations about plastic surgery from social media and other online sources, and artificial intelligence (AI) now functions both as a tool for analyzing that content and as a source of the content itself. This review maps original empirical studies that applied an AI or computational method beyond conventional statistical analysis to social media, online reviews, public digital images, surveys, or crowdsourced data in plastic surgery while reporting an outcome related to the perceptions, questions, experiences, or information exposure of patients or the public. Twenty-six studies published between 2019 and 2026 met inclusion criteria, 19 (73%) of them since 2024. Facial aesthetic surgery was the most represented domain (n = 9; 35%). RealSelf was the most common primary data source (n = 8; 31%), 18 studies (69%) analyzed a single platform, and 18 (69%) analyzed text alone. Sentiment or emotion analysis was the most common computational method (n = 13; 50%), and 16 studies (62%) applied pretrained models or lexicons as released, without training on study data. A human comparator was reported in 10 studies (38%) and external validation in 1 (4%). No study linked patient-generated digital data to a validated patient-reported outcome measure or evaluated these data for surgical education. Work at this intersection is expanding rapidly but remains descriptive, single-platform, and largely unvalidated.

Hairy cell leukemia (HCL), similar to its variant HCLv, is a B-cell malignancy associated with decreased humoral immunity. We prospectively monitored the largest cohort of patients with HCL/HCLv to date (n = 503) for COVID-19 by symptoms, antibody, and polymerase chain reaction (PCR) and/or antigen positivity. Fifty percent (253 of 503) of the patients with HCL/HCLv (238 HCL and 15 HCLv) had evidence of COVID-19, with 210 (83%) testing positive by PCR or rapid-antigen test. Of the 43 patients without positive tests, all had nucleocapsid antibodies indicating COVID-19 exposure, 7 recalled no symptoms, and 36 had mild symptoms. Of the 210 who tested positive, 23, 46, 129, and 12 cases occurred in 2020, 2021, 2022, and 2023, respectively. Among them, 175 began treatment for HCL/HCLv 0.4 to 429 (median, 66) months before, and 132 had their last dose of anti-CD20 monoclonal antibody 0.2 to 229 (median, 63) months before. Two patients died, including a young woman who began rituximab 2 months after first-line cladribine before vaccine availability. Nearly all patients with HCL/HCLv recovered uneventfully from COVID-19 including those without vaccination or those with significant immunosuppression and recent treatment. However, decreased normal B cells from HCL or treatment was associated with lower spike antibody levels as a response to COVID-19 (P = .0094) and longer recovery time (P = .0036). Thus, in a large cohort of patients with HCL/HCLv and in the first to determine relationships between COVID-19 outcome and immune markers, mortality was relatively low (∼1%), sequelae were uncommon, and recovery from COVID-19 was longer if normal B cells were low after recent treatment. The trials are registered at www.clinicaltrials.gov as #NCT01087333 and #NCT04362865.